CJEM
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Electrical cardioversion for atrial fibrillation/atrial flutter (AF/AFL) is common in the ED. Our previous work showed that hypotension and respiratory events were important adverse events that occurred in patients undergoing electrical cardioversion for AF/AFL. The purpose of this study was to examine if (1) beta-blockers or calcium channel blocker use prior to ECV were associated with hypotension and (2) medications used for procedural sedation were associated with respiratory events. ⋯ Beta-blocker or calcium channel blocker use prior to ECV for AF/AFL was not associated with hypotension. However, sedation with fentanyl and home beta-blocker use was associated with hypotension. The use of midazolam for procedural sedation was significantly associated with respiratory events.
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Mental practice is an effective method for skill acquisition in medicine. We describe the integration of interview-derived sensory cues with a list of procedural steps into a cohesive script to facilitate mental practice for a High Acuity, Low-Occurrence procedure, the bougie-assisted cricothyrotomy. Data collection occurred through interviews with emergency physicians. ⋯ On average, each participant identified 13.7 cues per procedure. This represents the first attempt to combine cues identified by practitioners along with procedural steps with the aim of supporting rich mental representations of a procedure. We expect that this script will be useful to physicians seeking to improve their skills in this rare procedure.
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Editorial Comment Randomized Controlled Trial
The third intensive care bundle with blood pressure reduction in acute cerebral haemorrhage trial (INTERACT3): an interactional, stepped wedge, cluster randomized controlled trial.